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Rrb ub 11 2026

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  1. Click ‘Get Form’ to open the rrb ub 11 in the editor.
  2. Begin by filling out Section A, which includes your identifying information such as name, social security number, and contact details.
  3. In Section B, provide details about your infirmity and employment history. Make sure to accurately enter the date you became sick or injured and the last date you worked.
  4. Complete Section C if applicable, detailing any accident or insurance information related to your claim.
  5. Move on to Section D where you will claim sickness benefits. Indicate the dates for which you are claiming benefits and ensure that you do not claim days worked or paid.
  6. Finally, review all sections for accuracy before signing and dating the form in Section F. Ensure that your doctor completes the attached Statement of Sickness (Form SI-1b).

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UB-11 (03/12) Sickness Benefits for Railroad Employees

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